No description available.

The purpose of this study was to begin testing of a downward cross-level model for studying the ability of older adults to transition from a nursing home after a Medicare Part A reimbursed stay. Transitions are known to be a weak point in the provision of healthcare to older adults and thus far, research has not identified those factors that influence older adult's transitions i.e., from the nursing home after a post acute stay. The theoretical background for this study was supported by Resource Dependency Theory which is a theory that contends that organizations are externally controlled by activities outside the organization such as the "free-market" economic model that predominates the nursing home industry. It was thought that nursing homes may prioritize their need for resident census above the resident's need for discharge. The hypothesis was that both individual resident characteristics and organizational characteristics might influence the ability of older adults to transfer from the nursing home after a Medicare Part A stay. The method of analysis in this study was contextual regression. Individual and facility characteristics were the independent variables and length of stay was the dependent variable. For this project, emphasis was placed on the development of a methodology for using the MDS in this and future research studies. Selection of variables and methods for variable computation were highlighted. Individual and facility characteristics and discharge disposition (level of care) were reported descriptively. Although facility characteristics did not contribute significantly to the model, individual characteristics explained 28% of the variance in the length of stay. Fifteen percent of individuals in the sample died during their Medicare Part A stay and 18% were readmitted to the hospital. The most prevalent diagnoses of the sample were hypertension (35%), falls (34%) and arthritis (32%). Findings suggest that individual characteristics account for only a portion of the length of stay for post acute nursing home residents. Further model testing is needed and should include a larger facility sample size and market characteristics to determine if those factors significantly influence the ability of older adults to transfer after the Medicare Part A stay ends.

No description available.

Bakgrund: Personer på äldreboende uppnår sällan allmänna rekommendationer för fysisk aktivitet. Detta kan medföra förlust av viktiga funktioner, något som fysisk aktivitet till viss del kan motverka. Syfte: Att utforska äldre personers uppfattning om fysisk aktivitet på ett äldreboende med inriktning ”sport och spa”. Syftet var även att undersöka de upplevda möjligheterna till fysisk aktivitet för personer på äldreboendet. Metod: En kvalitativ studie med semistrukturerade intervjuer. Två kvinnor och tre män mellan 67-97 år intervjuades. Deltagarna rekryterades via bekvämlighetsurval. Intervjumaterialet bearbetades med en kvalitativ innehållsanalys inspirerad av Graneheim och Lundman. Resultatsammanfattning: Utifrån frågeställningen uppfattning av fysisk aktivitet framkom följande tre kategorier: ”fysisk aktivitet nu och tidigare”, ”negativa effekter av fysisk aktivitet” samt ”positiva effekter av fysisk aktivitet”. Uttalanden gällande frågeställningen upplevelsen av möjlighet till fysisk aktivitet gav upphov till fyra kategorier: ”boendets resurser”, ”yttre förutsättningar”, ”individens förutsättningar” och ”grad av autonomi”. Slutsats: Stora variationer förekom i uppfattningen av fysisk aktivitet. Allt ifrån den egna vardagsmotionen till en mängd olika organiserade aktiviteter beskrevs. Fysisk aktivitet associerades även med biologiska och psykologiska effekter av träning. Möjligheten till att vara fysiskt aktiv påverkades av individens motivation och grad av autonomi. / Background: Elderly in nursing homes rarely achieves general recommendations for physical activity (PA). This may result in the loss of important functions, which PA can partially reduce. Purpose: To explore older people's perception of PA in a nursing home with the focus "sport and spa". The purpose of this study was also to investigate the perceived opportunities for PA for the elderly in a nursing home. Method: A qualitative study using semi-structured interviews were used. Three men and two women, between 67-97 years old, were interviewed. Qualitative content analysis was conducted. Results: Based on the informants􏰀perception of physical activity, the following three categories emerged: "physical activity now and earlier", "adverse effects of physical activity" and "positive effects of physical activity". Four categories described the experience of the possibility of physical activity among the informants, "the property's resources," "external conditions", "individual circumstances" and "degree of autonomy". Conclusions: Everyday exercise to a variety of organized activities were associated with PA. The concept of PA was also reported to include biological and psychological effects. The ability to be physically active was influenced by the individual's motivation and degree of autonomy.

As the son of parents of the "baby boomer" generation I foresee the immanent increased demand for assisted living for the elderly. By 2030 an estimated 20 percent - one in five Americans - will be 65 or older. Unless attention is paid now to advancing the designs and opportunities for assisted-living, there will either be a distinct lack of available options, or worse, the continuation of out-dated designs that simply will not be a marketable. Contemporary thinking with regard to the design of places of residence for the elderly has changed dramatically from the days of outdated structures and philosophies. In my research, I have seen a shift toward the concept of community rather than institution. Owing to cultural change that will surely be the future of assisted living design strategy. Yet, the shift is still in the rut of scaling designs to accommodate up to only a few dozen individuals. While I understand the rationale of such designs, I foresee a shortcoming to that approach. If the design idea is the drive toward the feeling of "home" then I feel it to be conceivable for an expansion of the current model to include multiple neighborhoods of residences, subsidiary structures, and more connection to a feeling of neighborhood and social interaction; the attributes of a true "community." What are missing are the environments that appeal to younger citizens. Baby boomers, easily described as much more educated, well-informed, well traveled, financially successful and much more discerning will not find the traditional options appealing or acceptable. My primary method of research for such an endeavor falls under the classification of Qualitative Research; the category that focuses on personal and informal social science. My design intention is not to separate and isolate the population of those seeking assisted living. Instead, offer more than just a place to live. I intend to discover validity for the concept of a larger networked residential community with more opportunity for social interaction and active lifestyle extending beyond what currently exists.

The healthcare industry, and more specifically the nursing home sector, is changing operations and services due to a healthcare mandates and enactment of the 2010 Affordable Care Act. Such changes are termed quality assurance performance improvements (QAPI), to receive government subsidies and indemnification compensations. The purpose of this single case study was to explore effective strategies implemented by 4 healthcare leaders to comply with QAPI regulations. Total quality management theory was the conceptual framework used in this study. Data were collected through semistructured, open-ended, face-to-face interviews with 4 participants who serve in a management capacity at an organization located in northwest Missouri. Member checking was used to strengthen the credibility and trustworthiness of the interpretation of the participants' responses. The emergent themes from the study were (a) quality planning using systematic and strategic approaches, (b) quality control using business instruments and tools to measure performance and progress, (c) quality assurance through internal and external systematic analysis, and (d) quality improvements using an integrated systems approach. The implications for positive social change include the potential optimization of care provided to consumers in nursing homes by identifying best practices and strategies healthcare and business professionals have used to modify their business processes and operations.

<p>At two nursing homes for people with dementia a qualitative study was performed. The purpose was to investigate the therapy dog‟s meaning to people with dementia from their perspective. Two women and five men with dementia were interviewed, everyone being somewhere between 60 and 87 years of age. All but one had previously owned a dog at some point in their lives. From the content analysis four categories could be identified: activity, fellowship, friendship and without positive meaning. The therapy dog had different meanings to the different people. The therapy dog had a positive meaning to five of the interviewed participants. Most of the participants had a positive approach to the therapy dog. It was considered to be good company and a good friend, as well as something to play and interact with. Two of the participants did not consider the therapy dog to be of any particular meaning to them, one of them showing disinterest for the subject. Knowledge about attitude to and experience of dogs for persons with dementia during the healthy part of life is important in order to have a well-established therapy with therapy dogs.</p> / <p>På två vårdboenden för personer med demens genomfördes en kvalitativ studie, med syftet att ta reda på vilken betydelse vårdhunden hade för dem ur deras eget perspektiv. Två kvinnor och fem män med demens inkluderades och intervjuades. De var mellan 60 och 87 år. Alla utom en hade tidigare haft egen hund. Ur innehållsanalysen framkom fyra kategorier: aktivitet, gemenskap, kamratskap och utan positiv betydelse. Vårdhunden hade olika betydelse för olika informanter. Flertalet av de intervjuade hade en positiv inställning till vårdhunden. Den var ett sällskap, en god kamrat och man lekte/hade aktivitet tillsammans. Två av de intervjuade tyckte inte att vårdhunden hade någon positiv betydelse, varav en uttryckte ointresse för vårdhunden. Kunskap om inställning till och erfarenhet av hundar under den friska levnadstiden hos personer med demens är viktig för att de ska uppfatta vårdhunden och terapin som positiv.</p>

The aim of this report is to understand the actual needs of older people who live in a nursing home in Sweden. Qualitative method was applied in order to collect data from interviews of both older people and staffs of the nursing home. Data analysis was performed by using hermeneutical circle. The results revealed the basic needs, the psychological needs, the self-fulfillment and the ‘needs and wants’ of older people. The results showed that the needs of older people were varied as individuals are unique. In general, the basic needs are for survival, and the needs of families, communications, personalized activities, and encouragement which might have the conductive function for older people to live a happy later life.

At two nursing homes for people with dementia a qualitative study was performed. The purpose was to investigate the therapy dog‟s meaning to people with dementia from their perspective. Two women and five men with dementia were interviewed, everyone being somewhere between 60 and 87 years of age. All but one had previously owned a dog at some point in their lives. From the content analysis four categories could be identified: activity, fellowship, friendship and without positive meaning. The therapy dog had different meanings to the different people. The therapy dog had a positive meaning to five of the interviewed participants. Most of the participants had a positive approach to the therapy dog. It was considered to be good company and a good friend, as well as something to play and interact with. Two of the participants did not consider the therapy dog to be of any particular meaning to them, one of them showing disinterest for the subject. Knowledge about attitude to and experience of dogs for persons with dementia during the healthy part of life is important in order to have a well-established therapy with therapy dogs. / På två vårdboenden för personer med demens genomfördes en kvalitativ studie, med syftet att ta reda på vilken betydelse vårdhunden hade för dem ur deras eget perspektiv. Två kvinnor och fem män med demens inkluderades och intervjuades. De var mellan 60 och 87 år. Alla utom en hade tidigare haft egen hund. Ur innehållsanalysen framkom fyra kategorier: aktivitet, gemenskap, kamratskap och utan positiv betydelse. Vårdhunden hade olika betydelse för olika informanter. Flertalet av de intervjuade hade en positiv inställning till vårdhunden. Den var ett sällskap, en god kamrat och man lekte/hade aktivitet tillsammans. Två av de intervjuade tyckte inte att vårdhunden hade någon positiv betydelse, varav en uttryckte ointresse för vårdhunden. Kunskap om inställning till och erfarenhet av hundar under den friska levnadstiden hos personer med demens är viktig för att de ska uppfatta vårdhunden och terapin som positiv.

Bakgrund: Äldre på boende idag kan känna att de saknar sociala interaktioner med vårdpersonal, familj eller vänner. För att uppleva god livskvalitet krävs bland annat trygghet, sociala interaktioner och aktiviteter. Djur kan användas som behandlingsmetod i vården i form av Animal-Assisted Activity (AAA) och Animal-Assisted Therapy (AAT). Syfte: Syftet med litteraturstudien var att belysa sällskapsdjurs betydelse för äldres livskvalitet på äldreboende. Metod: Studien har genomförts som en allmän litteraturstudie. Datainsamlingen har gjorts i databaser och med manuella sökningar. Resultat: I samband med djurinterventionen aktiverade vårdtagarna sina kroppar och blev mer rörliga. Positiva förändringar av sömnrutiner och aptit observerades också. Djurens närvaro påverkade vårdtagarnas känslor men även deras kognition, vilket gjorde att gamla minnen om egna djur återkom. De äldre samtalade mer med varandra och uppvisade ett förbättrat socialt beteende. Diskussion: Tre fynd diskuteras: vårdtagarnas fysiska aktivering, känslor och sociala interaktioner samt varför de boende påverkas av djurinterventioner. Slutsats: Djurinterventioner visade sig ge en positiv påverkan på livskvaliteten hos en del äldre på äldreboende och är något som skulle kunna användas mer i vården. / Introduction: Elderly residents today may feel that they lack social interactions with health professionals, family or friends. To experience good quality of life requires for example security, social interactions and activities. Animals can be used as treatment in health care in the form of Animal-Assisted Activity (AAA) and Animal-Assisted Therapy (AAT). Aim: The aim of this literature review was to elucidate pets’ importance for older people’s quality of life in nursing homes. Method: The study was conducted as a general literature review. Data collection has been made in databases and with manual searches. Results: When using animal interventions the residents activated their body and became more mobile. Positive changes in sleep routines and appetite were also observed. The animals’ presence affected residents’ feelings but also their cognition, which made old memories of their own animals return. The elderly talked more to each other and showed improved social behaviour. Discussion: Three findings are discussed: residents’ physical activation, emotions and social interactions, and why residents are affected by animal interventions. Conclusion: Animal interventions were found to have a positive impact on quality of life for some elderly in nursing homes and are something that could be used more in healthcare.